Developing a Mentalization-Based Couple Therapy Model to Improve Understanding of Spousal Intentions, Reduce Relational Misinterpretation, and Enhance Emotional Security
Keywords:
Mentalization, Couple Therapy, Relational Misinterpretation, Emotional Security, Spousal Intention, Thematic AnalysisAbstract
Objective: This study aimed to develop a qualitative model of mentalization-based couple therapy focused on improving the understanding of spousal intentions, reducing relational misinterpretation, and enhancing emotional security in marital relationships.
Methods and Materials: This qualitative study was conducted using thematic analysis. The study population consisted of married couples living in Tehran who reported recurrent conflicts, misinterpretation of their spouse’s behaviors, and emotional insecurity within the relationship. Participants were selected through purposive sampling. Semi-structured individual interviews were conducted with 24 married participants, including 12 women and 12 men. Inclusion criteria were being married for at least two years, living in Tehran, willingness to participate voluntarily, and experiencing relational conflicts rooted in misunderstanding or misinterpretation. Interviews continued until theoretical saturation was achieved. After transcription, data were analyzed using NVivo software through initial coding, code organization, development of subthemes, and extraction of main themes. To enhance trustworthiness, member checking, peer review, analytic memo writing, and constant comparison were applied.
Findings: Data analysis led to the emergence of five main themes: collapse of mentalization under emotional arousal, hostile attribution and certainty in reading the spouse’s mind, emotional insecurity and defensive relational cycles, reconstruction of mentalizing curiosity in couple dialogue, and formulation of a phased mentalization-based couple therapy model. The findings indicated that relational misinterpretation intensifies when spouses treat the partner’s behavior not as an ambiguous relational signal to be explored, but as definite evidence of rejection, indifference, or lack of love.
Conclusion: The proposed model suggests that mentalization-based couple therapy may improve marital interaction by reducing interpretive certainty, strengthening reflective pause, regulating emotional arousal, and fostering curiosity-based dialogue. These processes can contribute to more accurate understanding of spousal intentions and greater emotional security.
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References
Allen, J. G., Fonagy, P., & Bateman, A. W. (2008). Mentalizing in clinical practice. American Psychiatric Publishing.
Asen, E., & Fonagy, P. (2012). Mentalization-based therapeutic interventions for families. Journal of Family Therapy, 34(4), 347–370. https://doi.org/10.1111/j.1467-6427.2011.00552.x
Bateman, A. W., & Fonagy, P. (2010). Mentalization based treatment for borderline personality disorder. World Psychiatry, 9(1), 11–15. https://doi.org/10.1002/j.2051-5545.2010.tb00255.x
Bateman, A. W., & Fonagy, P. (2016). Mentalization-based treatment for personality disorders: A practical guide. Oxford University Press.
Bowlby, J. (1988). A secure base: Parent-child attachment and healthy human development. Basic Books.
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101. https://doi.org/10.1191/1478088706qp063oa
Fonagy, P., & Allison, E. (2014). The role of mentalizing and epistemic trust in the therapeutic relationship. Psychotherapy, 51(3), 372–380. https://doi.org/10.1037/a0036505
Fonagy, P., Gergely, G., Jurist, E. L., & Target, M. (2002). Affect regulation, mentalization, and the development of the self. Other Press.
Gottman, J. M., & Levenson, R. W. (2000). The timing of divorce: Predicting when a couple will divorce over a 14-year period. Journal of Marriage and Family, 62(3), 737–745. https://doi.org/10.1111/j.1741-3737.2000.00737.x
Hertzmann, L., & Nyberg, V. (2018). A partnership of two therapeutic models: The development of mentalization based treatment—couple therapy (MBT-CT) within a psychoanalytic framework. Couple and Family Psychoanalysis, 8(1), 23–37.
Johnson, S. M. (2004). The practice of emotionally focused couple therapy: Creating connection (2nd ed.). Brunner-Routledge.
Johnson, S. M. (2007). The contribution of emotionally focused couples therapy. Journal of Contemporary Psychotherapy, 37, 47–52. https://doi.org/10.1007/s10879-006-9034-9
Lincoln, Y. S., & Guba, E. G. (1985). Naturalistic inquiry. Sage.
Luyten, P., Campbell, C., Allison, E., & Fonagy, P. (2020). The mentalizing approach to psychopathology: State of the art and future directions. Annual Review of Clinical Psychology, 16, 297–325. https://doi.org/10.1146/annurev-clinpsy-071919-015355
Mikulincer, M., & Shaver, P. R. (2016). Attachment in adulthood: Structure, dynamics, and change (2nd ed.). Guilford Press.
Nowell, L. S., Norris, J. M., White, D. E., & Moules, N. J. (2017). Thematic analysis: Striving to meet the trustworthiness criteria. International Journal of Qualitative Methods, 16(1), 1–13. https://doi.org/10.1177/1609406917733847
Tong, A., Sainsbury, P., & Craig, J. (2007). Consolidated criteria for reporting qualitative research: A 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care, 19(6), 349–357. https://doi.org/10.1093/intqhc/mzm042
Wiebe, S. A., & Johnson, S. M. (2016). A review of the research in emotionally focused therapy for couples. Family Process, 55(3), 390–407. https://doi.org/10.1111/famp.12229
